Provider Demographics
NPI:1104966431
Name:MOLINA, SONIA MUNIZ (CRNA)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:MUNIZ
Last Name:MOLINA
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:SONIA
Other - Middle Name:MUNIZ
Other - Last Name:BONILLA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA
Mailing Address - Street 1:3100 SPRING FOREST RD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-2880
Mailing Address - Country:US
Mailing Address - Phone:919-873-9533
Mailing Address - Fax:
Practice Address - Street 1:2308 WESVILL CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2949
Practice Address - Country:US
Practice Address - Phone:919-781-4311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC45491367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8050387Medicaid
NC430040156OtherRAILROAD-MEDICARE
NC430040156OtherRAILROAD-MEDICARE